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General NPI Number Information
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NPI Number | 1952630030
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Entity Type | Individual
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Provider Name | AMY AGATHA DAMON LPN
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Gender | Female
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 115-23 224 STREET
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City | JAMAICA
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State | NY
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Zip | 11411-2220
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Country | US
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Telephone | 718-723-7516
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Fax | 718-723-7516
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Provider Business Mailing Address
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Address Line | 120-38 231 STREET
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City | JAMAICA
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State | NY
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Zip | 11411-2220
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Country | US
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Telephone | 718-723-7516
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Fax | 718-723-7516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 296991-1
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License Number State | NY
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